Individual provider Active NPI

Yanjun Shi, MD

  • Surgery Physician
  • Richmond, VA
National Provider Identifier
1790126530
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0109542089 Issued in VA
Practice address
1250 E Marshall St
Department of Surgery
Richmond, VA 23298-5051
Phone
(804) 828-9298
Fax
(804) 828-4858
NPI assigned
Jul 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0109542089 VA Primary
Transplant Surgery Physician 204F00000X 0109542089 VA

Addresses

Primary practice location

1250 E Marshall St
Department of Surgery
Richmond, VA 23298-5051

Mailing address

PO Box 91734
Richmond, VA 23291-1734
Phone (804) 358-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0109542089VAMDSurgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1790126530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91734",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232911734",
            "telephone_number": "804-358-6100",
            "fax_number": "804-342-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985051",
            "telephone_number": "804-828-9298",
            "fax_number": "804-828-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHI",
        "first_name": "YANJUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0109542089",
            "primary": true
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "VA",
            "license": "0109542089",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.